ESTRO 36 Abstract Book

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S357 ESTRO 36 2017
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alive, 3 died due to the cancer progression of the tumors
except ones received the C-ion RT, 5 developed a local
recurrence. The 1-year OS of the CRC group and the non-
CRC group, the larger tumor group (> 50mm) and the
smaller tumor group, the 4-fraction group and the 12-
fraction group were 100% and 75% (p value=0.16), 81 % and
100% (p=0.078), 94% and 80% (p=0.030), respectively. The
1-year LCR of those were 70% and 100% (p=0.13), 56% and
100% (p=0.080), 80 % and 75% (p=0.95), respectively. No
Grade 3 and worse adverse reactions were observed. No
patients experienced radiation-induced liver disease.
Conclusion
It is suggested the C-ion RT for MLT is an effective and safe
treatment even in large MLT. This is the initial result thus
it is necessary to analyze more number of patients and for
longer observation period.
PO-0691 Whole-body total lesion glycolysis is an
independent predictor of thoracic esophageal cancer
N. Takahashi 1, R. Umezawa 1, K. Takanami2, Y. Takaya1,
Y. Ishikawa1, M. Kozumi1, K. Takeda1, N. Kadoya1, K.
Jingu1
1 Tohoku University Graduate School of Medicine,
Radiation oncology, Sendai, Japan
2 Tohoku University Graduate School of Medicine,
Diagnostic Radiology, Sendai, Japan
Purpose or Objective
The purpose of this study was to determine whether
pretreatment whole-body metabolic tumor volume
(MTV WB) and total lesion glycolysis (TLGWB) are associated
with outcomes in patients with thoracic esophageal
squamous cell carcinoma treated by definitive
chemoradiotherapy (dCRT).
Material and Methods
We retrospectively reviewed patients with stage II or III
thoracic esophageal squamous cell carcinoma who
underwent FDG-PET/CT within 60 days before dCRT at our
institution between January 2005 and August 2013.
Patients who had massive pneumonia caused by
perforation of the tumor at FDG-PET/CT were excluded.
Ninety patients were enrolled in this study. We calculated
all lesion’s SUVmax, SUVmean, MTV and TLG by using MIM
maestro TM ver. 6.6.1 (MIM Software Inc. USA). TLG was
calculated from MTV × SUV mean. TLGWB was sum of TLG of
primary lesion (TLGpri) and lymph-node lesions. MTVWB was
sum of MTV of primary lesion (MTVpri) and lymph-node
lesions. Survival estimates were calculated using the
Kaplan-Meier method from the first date of dCRT.
Predictors were analyzed using Cox’s hazards model.
Results
The median follow-up period was 64.2 months for
survivors. Three-year overall survival (OS), local control
(LC) and progression free survival (PFS) were 52.0 %, 42.7
% and 35.2 %, respectively. In univariate analysis, T stage
(p = 0.019, hazard ratio [HR]: 1.73), MTVpri ≥ median (p =
0.025, HR: 1.95), TLGpri ≥ median (p = 0.035, HR: 1.88),
MTV WB ≥ median (p = 0.004, HR: 2.38) and TLGWB ≥ median
(p = 0.007, HR = 2.25) were significant unfavorable
predictors of OS. TLGpri ≥ median (p = 0.016, HR: 1.99),
MTV WB ≥ median (p = 0.030, HR: 1.86) and TLGWB ≥ median
(p = 0.012, HR = 2.05) were significant unfavorable
predictors of LC. T stage (p = 0.007, HR: 1.65), 1 cycle of
concurrent chemotherapy (p = 0.021, HR: 2.14), SUVmax (p
= 0.033, HR: 1.76), SUVmean (p = 0.019, HR: 1.85), TLGpri ≥
median (p = 0.009, HR: 1.99), MTV WB ≥ median (p = 0.006,
HR: 2.06) and TLGWB ≥ median (p = 0.002, HR = 2.26) were
significant unfavorable predictors of PFS. Factors with p <
0.1 in univariate analysis were included in multivariate
analysis. In multivariate analysis, MTV WB ≥ median (p =
0.016, HR: 2.34) and TLGWB ≥ median (p = 0.013, HR = 2.34)
were significant unfavorable predictors of OS. TLG pri ≥
median (p = 0.023, HR: 2.17), MTV WB ≥ median (p = 0.020,
HR: 2.18) and TLGWB ≥ median (p = 0.007, HR = 2.50) were
significant unfavorable predictors of LC. MTVpri ≥ median
(p = 0.0495, HR: 1.83), TLGpri ≥ median (p = 0.024, HR:
2.01), MTVWB ≥ median (p = 0.003, HR: 2.44) and TLGWB ≥
median (p = 0.008, HR = 2.79) were significant unfavorable
predictors of PFS. SUVmax was not selected as a predictor
of OS, LC or PFS.
Conclusion
In multivariate analysis, MTVWB and TLGWB were
independent predictors for OS, LC and PFS. In addition,
the hazard ratio of TLGWB was highest for OS, LC and PFS
in multivariate analysis. TLGWB is one of best predictor in
patients with stage II or III thoracic esophageal squamous
cell carcinoma treated by dCRT.
PO-0692 The role of adjuvant chemoradiotherapy in
patients with common bile duct cancer after R1
resection
S.W. Kim1, S.H. Kang2, M. Chun 1, Y.T. Oh 1, O.K. Noh1, H.
Jang3, S. Jo4
1Ajou University School of Medicine, Radiation Oncology,
Suwon City, Korea Republic of
2Ilsan Paik Hospital- Inje University School of Medicine,
Radiation Oncology, Goyang, Korea Republic of
3Dongguk University School of Medicine Gyeongju
Hospital, Radiation Oncology, Gyeongju, Korea Republic
of
4Haeundae Paik Hospital- Inje University School of
Medicine, Radiation Oncology, Busan, Korea Republic of
Purpose or Objective
We investigated the role of adjuvant radiotherapy
combined with chemotherapy (CRT) in patients with
microscopically positive resection margin after curative
resection for extrahepatic cholangiocarcinoma (EHCC).
Material and Methods
We included 87 patients with EHCC treated with curative
surgery at our institution. Of the 35 patients with
microscopically positive resection margin, 22 patients
received adjuvant chemoradiotherapy (R1 + CRT group)
and 13 received adjuvant radiotherapy alone (R1 + XRT
group). We compared treatment outcomes between these
patients and 52 patients with negative resection margin
who did not receive any adjuvant treatments (S group).
Results
Patients in R1 + CRT and R1 + XRT group were younger than
those in S group and pathologically positive lymph node
was more common in R1 + CRT group. During the median
follow-up period of 26 months, the 2-year disease-free
survival rates were 55.8% for S group, 54.5% for R1 + CRT
group and 9.6% for R1 + XRT group. There was no
significant difference in disease-free survival rate
between S group and R1 + CRT group (p = 0.225). In
contrast, R1 + XRT group had significantly inferior 2-year
disease-free survival rate compared with S group ( p =
0.013) and R1 + CRT group (p = 0.008). In multivariate
analysis, R1 + XRT group had a trend for increased risk of
recurrence (HR, 2.049; 95% CI, 0.930–4.514; p = 0.075).
The 2-year overall survival rates were 61.5% for S group,
54.5% for R1 + CRT group and 15.4% for R1 + XRT group.
There was significant difference in 2-year overall survival
rate between R1 + XRT group versus S group (p <0.001) and
R1 + CRT group (p = 0.021). Multivariate analysis revealed
that R1 + XRT group had an increased risk of mortality (HR,
2.497; 95% CI, 1.242–5.019; p = 0.010).
Conclusion
Adjuvant CRT after R1 resection showed equivalent
survival rates to R0 resection without adjuvant
treatments, whereas adjuvant radiotherapy alone after R1
resection had significantly worse survival outcomes
compared with other groups. As adjuvant CRT had superior
outcomes to adjuvant radiotherapy alone in patients with
R1 resection, adjuvant CRT might be a better option for
controlling microscopic residual EHCC.
PO-0693 Stereotactic radiotherapy in hepatocellular
carcinoma: a systematic review